Is teardrop, textured, round, or smooth better for breast reconstruction?

I use the shaped devices (textured, teardrop) in probably 95% of my reconstructions and 50% of my breast augmentations.  I think they are wonderful implants and in the right hands, provide a natural look that lasts and keeps things where they are supposed to stay.  They come in many shapes, sizes, projections and widths, so choosing the perfect implant for your body and your goals is CRITICAL!! Hope this helps.-JGH

The choice between the type of implant I use on reconstruction cases depends on the shape of the patient's breast following mastectomy. If there is a very anatomic shape without much "give" of the expander (ie. it already looks like a good shape and is tight to the underlying implant), then I think the form stable shaped implants work well. Except for the taller patients with long trunks, I have  stopped using the full height (tear drop) implants on those cases as the top of the implant tends to create a shelf sometimes. The medium height shaped implants are the most forgiving. In patients with looser pockets around the expander or more work needed on the skin, a round implant is usually the easier choice.

Excellent question. This is something that is still hotly debated within the plastic surgery community with strong opinions on both sides. In the setting of breast reconstruction where you don't have your own breast tissue to cover the implant I thing that shaped (teardrop, textured) implants provide the most natural results. There is a smoother transition from the top of the chest to the breast rather than an abrupt border one would have with a round implant. That upper border could be smoothed out with fat grafting. All shaped implants are textured because it is critical that they maintain their orientation and position and the texturing helps to hold them in place. Textured implants also have the benefit of maintaining their position over time and not dropping or displacing laterally into the armpit area. If you do elect to go with shaped implants make sure that your surgeon has experience with them and uses them for the majority of his/her breast reconstructions because there is definitely a learning curve and subtle technical differences between using shaped and smooth round implants. Good Luck.